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Study: Some new moms get too little advice from doctors

Kim Painter
Special to USA TODAY
Some mothers say doctors never talk to them about health and safety issues, including safe sleep positions for babies. This  photo illustrates a safe sleep position -- on the back -- on a firm mattress.

New mothers get a lot of advice, but when it comes to key issues of infant health and safety, some moms hear surprisingly little from doctors, a new study shows.

The study, published Monday inPediatrics, does show moms get more advice from doctors and nurses than from family members and the media on vaccinations, breastfeeding, pacifier use and sleep safety. Advice from health professionals also is more likely to match recommendations from the American Academy of Pediatrics.

But in the nationally representative survey of more than 1,000 mothers of infants, 75% said they heard nothing from doctors about pacifier use and more than 50% said they heard nothing about where babies should sleep – for example, in their own cribs or in parents' beds.

About 20% reported no doctors' advice on breastfeeding or how infants should be positioned for sleep. And 11% said doctors offered no advice on vaccinations.

"The amount of 'no advice' we found was a little surprising," says lead author Staci Eisenberg, a pediatrician at Boston Medical Center. "We know that advice matters. We know from previous studies that mothers getting advice from more sources, and more correct advice, changes behavior."

The pediatrics group has stances on all of the issues covered in the survey. For example, it says babies should always be put to sleep on their backs and should sleep near parents, but in their own cribs or bassinets, to lower risks of sudden infant death syndrome (SIDS). The group recommends breastfeeding for a least a year and says pacifiers used at nap and bedtime can lower SIDS risks.

When doctors do give advice on those issues, it usually matches those guidelines, mothers reported. But there were exceptions: 26% heard differing advice on sleep positions and 29% heard differing advice on sleep location.

And when mothers got advice elsewhere, especially from non-professionals, it was more likely to vary. For example, 32% said family members gave differing advice on sleep positions – usually endorsing the discredited idea that babies should sleep on their stomachs.

The study, funded by the National Institutes of Health, did not look at why some doctors stay mum. But the authors speculated that some may be unaware of or disagree with official recommendations and that others may want to avoid potentially contentious, lengthy discussions or may just run out of time.

The study suggests doctors do not give advice equally: Black, Hispanic and first-time mothers reported more advice than white and experienced mothers.

"We would hope that doctors are not making assumptions about which moms need information and which don't," Eisenberg says.

Shanon Nebo, 32, of Annapolis, Md., says she got no advice on breastfeeding from health professionals when she tried unsuccessfully to breastfeed her first son 11 years ago. But she got advice she did not agree with when she took her then 1-month-old second son to a pediatrician recently and was urged to stop sharing a bed with him.

Despite that "tense discussion" (and the fact that it did not change her mind), she wants pediatricians to share advice, as long as it's not a one-way lecture, she says: "We don't need pediatricians telling us what to do, but moms do need advice from them. That's what we pay them for."

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